Health Insurance and Managed Care (B) Committee

The following task forces and working groups report to the Health Insurance and Managed Care (B) Committee:

• Consumer Information (B) Subgroup
• Exchanges (B) Subgroup
• Health Actuarial (B) Task Force
• Regulatory Framework (B) Task Force
  • ERISA (B) Working Group
• Senior Issues (B) Task Force
  • Medigap PPACA (B) Subgroup

Mission

The mission of the Health Insurance and Managed Care (B) Committee is to consider issues relating to all aspects of health insurance.

2013 Charges  

Ongoing Maintenance of NAIC Programs, Products or Services

1. Respond to inquiries from Congress, the White House and federal agencies; analyze policy implications and effect on states of proposed legislation; communicate NAIC's position through letters and testimony when requested.—Essential
2. Monitor the activities of the Health Actuarial (B) Task Force.—Essential
3. Monitor the activities of the Regulatory Framework (B) Task Force.
   —Essential
4. Monitor the activities of the Senior Issues (B) Task Force.—Essential
5. Oversee changes and provide technical assistance as appropriate to the production of the Accident and Health Statistical Compilation and Market Share Report. Periodically evaluate the demand, utility and income derived from these reports versus their cost.—Essential
6. Review issues surrounding the uninsured/underinsured and strategies for achieving universal coverage, determine what contributions state insurance regulators, from their unique perspective, can make to the debate, and develop appropriate vehicles to convey any positions or principles the committee develops to a multiplicity of audiences.—Essential
7. Serve as the official liaison between NAIC and the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), the National Committee on Quality Assurance (NCQA), and URAC.—Important
8. Review issues surrounding evidence-based medicine and determine whether rigorous and consistent reporting should be required. If so, develop a model law on the topic or recommend another appropriate vehicle to achieve goals.—Important
9. Examine issues and, as necessary, state laws and/or regulations regarding appropriate underwriting questions on applications for health insurance coverage particularly with respect to ensuring that underwriting practices and HIV testing procedures are nondiscriminatory; and, if appropriate, develop a model law or model bulletin to reflect state law and/or regulations on the subject.—Important
10. Review the need for a model law or regulation or other vehicle to address and ensure appropriate producer participation in assisting employers and individual consumers making health care insurance purchase decisions for products sold inside and/or outside of health insurance exchanges, make appropriate drafting recommendations and make recommendations to the Secretary of Health and Human Services (HHS) regarding guidelines for producer participation in health insurance exchanges.—Important
11. Appoint a Health Care Reform Regulatory Alternative Working Group to: 1) provide a forum for discussion of and guidance on the alternatives to implementing an ACA-compliant state-based Exchange and the implications of such alternatives to NAIC member regulatory authority; 2) identify and assist NAIC members in resolving open issues that need to be addressed with regard to non-state Exchange ACA alternatives; 3) analyze the impact of the ACA on existing NAIC member regulatory authority both inside and outside of a federal Exchange as well as the impact on NAIC model laws(Unfair Insurance Practices Act, Producer Licensing Model Act, Model Law on Examinations, etc.); and 4) identify opportunities for NAIC members to continue to innovate and regulate outside of a federal Exchange.—Essential